Predisposition to nephropathy in Polynesians is associated with family history of renal disease, not diabetes mellitus

SUMMARY Aims  Familial clustering of diabetes and nephropathy suggests that either common environmental or inherited mechanisms are important in developing diabetic nephropathy. If an inherited mechanism is important, the albumin excretion rate might be increased in those at future risk. This study aimed to determine whether people with a family history of diabetes or people with a family history of renal disease were most at risk.Methods  In a two‐by‐two factorial study of urinary albumin in non‐diabetic Polynesians, 90 people with a first degree relative (FDR) with end‐stage renal failure (ESRF) and diabetes (group 1) were compared with 90 people with a FDR with non‐diabetic ESRF (group 2), with 90 people with a FDR with diabetes but no known nephropathy (group 3) and 90 people with no known relatives with either diabetes or nephropathy (group 4). Groups were matched for ethnicity and age.Results  Subjects with a family history of ESRF (groups 1 and 2) had an increased mean albumin–creatinine ratio (1.25 vs. 1.00 mg/mmol, P = 0.01), but in subjects with a family history of diabetes (groups 1 and 3), the mean ratios were not significantly different from those without a family his